Community health workers (CHWs) are frontline workers who fill key roles in delivering primary healthcare services to many of the underprivileged parts of Nigeria. They are also closely linked to their communities, and therefore in a very good position to help facilitate preventive health measures with regard to sanitation, diet, and family planning. CHWs provide basic medical care that includes immunization and treatment for common illnesses. They are also the bridge between communities and formal health facilities, referring patients to specialized care when needed. Besides direct treatment of patients, they gather vital health data, mobilize communities, and improve general Public Health outcomes. They rather significantly enhance the access to healthcare and put Nigeria on track toward attaining Universal Health Coverage.
In Nigeria, these workers exist in different forms with specified roles and training. For example, the village health workers (VHWs) are usually residents of the community who have received basic training to offer some essential healthcare services. They focus on health education, immunization, and referral of patients to larger health facilities. Most often, they form the first point of contact for the residents on issues concerning health. VHWs provide some sort of integration between the rural population and formal healthcare institutions. They are usually engaged in health education, advising on preventive measures such as vaccination and sanitation, and referring ill persons to healthcare facilities. Thus, very fundamentally, VHWs enlarge access to healthcare, particularly where Infrastructure for health infrastructure is minimal. Mostly, they volunteer or receive a minimal resource in return—a pointer to their deep-rooted interest in their communities’ wellbeing.
WDAs, CHEWs and AHWs are varieties of community health workers.
Although their roles differ in terms of the needs that are to be met in the community and in terms of intensity of training received, all are integral parts of the system of primary healthcare in Nigeria. On the other hand, community health extension workers (CHEWs) are further trained to a larger degree and, therefore, offer higher-order services, including maternal and child health, family planning, and treatment for common illnesses. While their roles can vary depending on the specific needs of the community and the level of training provided, they are recognized as vital assets in Nigeria’s primary healthcare system.
Meanwhile, Community Health Extension Workers (CHEWs) have more advanced training and offer a wider range of services, including maternal and child health, family planning, and treatment for common illnesses. Ward Development Agents (WDAs) primarily work on rural development but also assist with health-related tasks, collaborating with CHWs to enhance community health. Then, adolescent health workers (AHWs) specialize in addressing health issues for teenagers, offering Education on sexual health, HIV/AIDS prevention, and other related topics. They are health workers but with higher training compared to the VHWs. In principle, they are trained to offer an extended package of health service to the communities, more so in the rural areas and underserved communities.
Traditional attendants and faith workers also play their role.
CHEWs often work closely with health facilities, so they act as a bridge between the community and the formal healthcare system. The core competencies identified at this level include preventive healthcare, maternal and child health services, family planning, treatment of common ailments, health education, and forming a part of the important health data gathering and monitoring of health status within a community. With the high skills and knowledge acquired from training, CHEWs will be better placed in providing comprehensive health services to improve the general health status within communities.
Also, ward development agents (WDAs) are essentially community development workers focused on integrated rural development. While their direct responsibilities are in the domains of agriculture, engineering, and education, their work nature constantly overlaps into health areas. WDAs are commonly engaged in mobilization at community levels for health initiatives and in support of health activities by CHWs. They can also participate in health supplies distribution and health awareness programs, healthcare infrastructure development, etc. Even though they are not directly related to the practice of healthcare professionals, WDAs become relevant intermediaries between the community and services focused on health and part of the structure for improving community well-being in general.
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Additionally, traditional birth attendants (TBAs) and faith-based health workers constitute a core but informal part of healthcare delivery in Nigeria, particularly in rural areas. TBAs are experienced women who have a close affiliation with their communities and thus offer helpful assistance during delivery and postpartum care. Their practices can be dangerous without formal medical training. It may integrate the TBAs into the health system through training and collaborative working to improve the health status of mothers and children. Faith-based health workers are usually based in religious institutions, using their religious influence to promote health, prevent disease, and offer basic healthcare. Their effectiveness depends on the quality of training and the degree of its adherence to evidence-based practices, as well as the degree to which they are integrated into the formal healthcare system.